Should patients be allowed to discriminate?

[Eastfield Lodge]

As much as I disagree with it, their care comes first and foremost.

[Patriqvinia]

Of course... though I imagine in NHS countries this is probably a bit trickier as everyone's pilfered cash being dumped into a pool tends to create an "at least you got that much" mentality and the inevitable "but what about muh X" when there are complaints regarding that.

This "pilfering cash" system seems to produce better health outcomes for less cash, so maybe it's not such a bad idea.

"Seems to" and "maybe" are rather poor justifications for extortion.

[AiliailiA]

You can pick the professors you get, you do that by not turning up to lectures given by some professors. You will probably fail your class, but that is just a consequence of being retarded.
Public organisations (such as hospitals or universities) should not go out of their way to accommodate for those people (ie. they shouldn't spend a penny more to get a practitioner with <insert characteristics>) but that is not to say they should forcibly treat the patient against their will. Make patient aware that no practitioner with characteristics they want is available, if the patient still chooses to not be treated get them a pen and indemnification agreement, go and treat someone who actually wants the treatment.

Then it is basically:
1.Retarded is dying
2. Retarded wants a <insert characteristics> doctor
3. Retarded is warned that there is no <insert characteristics> doctor in the Hospital
4. Retarded stops being retarded and gets any doctor or Retarded stops being Retarded, forever.

(I edited plot twist numbers into your post)

1. Precept accepted. Not all Casualty patients are dying, but for the sake of argument ...
2. On-topic. Patient discriminates on grounds you or I would consider irrelevant to the quality of medical treatment.
3. This is pretty unlikely, for all likely values of <characteristic>, but let's assume the patient asked for a double-amputee doctor who speaks fluent Klingon ... for the sake of argument ...
4. The patient realizes that their demand is unreasonable and settles for "second best" practitioner (anyone in the building who speaks Klingon), gets sedated and then treated. Or they don't. They leave the hospital as sick as they came in or they fucking die.

Even with most generous interpretation of your argument, I see some people fucking dying by the application of a harsh principle.

I don't like racists or sexists myself. But I don't want them denied urgent medical treatment just because of their wrong beliefs. I don't want them left to die in a hospital, and I don't want them dying in a taxi or ambulance on the way to some other hospital. That is just too harsh a punishment for holding a wrong belief.

If we're going to sink to that level, then fuck having doctors at all. Get your "medical services" at market price and let the buyer beware.

[AiliailiA]

This "pilfering cash" system seems to produce better health outcomes for less cash, so maybe it's not such a bad idea.

"Seems to" and "maybe" are rather poor justifications for extortion.

OK, then. Taxpayer funded national health care DOES produce better health care outcomes for less cash. It's a CLEARLY BETTER idea than private-sector health insurance.

And it does justify "extortion". Easily.

You're an out-of-practice Ronpaulite. Give it up already. All the cool kids are fascists now.

[Great Nepal]

(I edited plot twist numbers into your post)

1. Precept accepted. Not all Casualty patients are dying, but for the sake of argument ...
2. On-topic. Patient discriminates on grounds you or I would consider irrelevant to the quality of medical treatment.
3. This is pretty unlikely, for all likely values of <characteristic>, but let's assume the patient asked for a double-amputee doctor who speaks fluent Klingon ... for the sake of argument ...
4. The patient realizes that their demand is unreasonable and settles for "second best" practitioner (anyone in the building who speaks Klingon), gets sedated and then treated. Or they don't. They leave the hospital as sick as they came in or they fucking die.

3. I would consider this likely for health practice operating at peak efficiency. Doctors operating in those practices must all be either be involved actively in care of other patients, be awaiting another patient or be on call for actual emergency (major accident etc). These doctors can not be pulled out of their positions without negetively impacting care of other patients or depliting the reserve; both are unacceptable. Alternatively, hosptial can call a doctor for overtime which is poor use of limited funds therefore unacceptable.

Even with most generous interpretation of your argument, I see some people fucking dying by the application of a harsh principle.

I don't like racists or sexists myself. But I don't want them denied urgent medical treatment just because of their wrong beliefs. I don't want them left to die in a hospital, and I don't want them dying in a taxi or ambulance on the way to some other hospital. That is just too harsh a punishment for holding a wrong belief.

If we're going to sink to that level, then fuck having doctors at all. Get your "medical services" at market price and let the buyer beware.

I don't.
Patient in question was capable of giving consent. The said patient were also made aware of consequences of withholding said consent. By withholding said consent, the patient can be considered at fault for any and all consequences thereafter (provided they were made aware of these); therefore any resultant harm (upto and including death) to the patient is no longer the responsibility of hospital or medical practitioner but of the patient.

[Orham]

That is frankly worse than a doctor refusing to treat a patient. It would take a few minutes to find some other doctor in the same hospital (though that is bad, as I said before) but at least in the meantime the patient is in a hospital, and if they develop acute symptoms and need urgent treatment it's there for them. If they're still able to give or withhold consent, they will buck up and accept the medical council of Dr. Wickramasingh, or lie there dying while they wait for Dr White to finish some other urgent medical appointment.

Is that harsh punishment for being a racist? Yes, but harsh decisions need to be made in Emergency. YOUR alternative — "go to some other hospital" — is just as harsh, and negligent of the patient's health and life to boot.

There may not be a Dr. White to find at that institution. I mean, suppose the patient is obstinate about their refusal to be treated by anyone who isn't of a specific ethnicity/race, or a specific religious affiliation, or whatever, but there's no one on staff qualified to provide the needed treatment which also meets the patient's criteria? It's perfectly conceivable that a patient who comes to a surgical clinic seeking care for appendicitis might have to swallow that this clinic just doesn't have a Mahayana Buddhist surgeon on staff.

Also, absolutely any danger created for the patient's health in this hypothetical is of their own creation. As you said, they're already in a hospital, and furthermore I provided that this hypothetical hospital has people on staff that are perfectly willing to treat them. I even provided the patient the option of abandoning the problematic criterion and accepting care or seeking care at an alternative institution.

Now, I'd be willing to bend a bit and say that a clinic ought to be required to provide emergency transportation to an alternative institution which is better able to reasonably provide for the patient's treatment criteria if, and only if, all of the following holds true:

(a) The situation warrants emergency transportation.
(b) An alternative institution which can better provide for the patient's criteria is reasonably available.
(c) The institution to provide emergency transportation has the capacity to do so.
(d) Transportation of this sort is at the patient's own personal expense.

That seems like a reasonable accommodation to me, providing transportation if it's needed and requested.

Best case scenario really is that the racist (or sexist, or whatever) patient passes out, and the doctors decide what is best for them. Dr Wickramasingh saves the racist's life, and the racist stops being so racist when they realize they owe their life to a "Paki".

Really, the best case scenario is that the patient either willingly abandons the problematic criteria and receives care before passing out, or is successfully transported to an alternative institution where their criteria can be more adequately provided for. Also, I hasten to add that forcible provision of treatment against the patient's specified criteria is, irrespective of their ability to consent at the point treatment is actually provided, a violation of bodily sovereignty. It's a warranted violation, but it's still a violation.

Actually I think yes. "Go to some other hospital" infringes on the rights of the patient which — while not always guaranteed by law outside the hospital — doctors specifically swore to protect when they entered their professional guild.

The specific concern I addressed was violation of bodily sovereignty. There is no violation of bodily sovereignty in telling a patient who wants a Mahayana Buddhist surgeon to remove their appendix that there is no such surgeon on staff, and that an alternative institution will have to be sought if this criterion is not abandoned. The problem of avoiding inflicting harm is resolved by providing emergency transportation to an alternative institution at the patient's expense or (if the situation warrants) providing care in contravention of the patient's demands for a Mahayana Buddhist surgeon.

[Ereria]

I think they should be able to choose gender because you know, maybe they don't want a woman doctor to see their penis or something, but other than that it shouldn't be allowed to request another doctor of different race or anything like that.

[AiliailiA]

(I edited plot twist numbers into your post)

1. Precept accepted. Not all Casualty patients are dying, but for the sake of argument ...
2. On-topic. Patient discriminates on grounds you or I would consider irrelevant to the quality of medical treatment.
3. This is pretty unlikely, for all likely values of <characteristic>, but let's assume the patient asked for a double-amputee doctor who speaks fluent Klingon ... for the sake of argument ...
4. The patient realizes that their demand is unreasonable and settles for "second best" practitioner (anyone in the building who speaks Klingon), gets sedated and then treated. Or they don't. They leave the hospital as sick as they came in or they fucking die.

3. I would consider this likely for health practice operating at peak efficiency. Doctors operating in those practices must all be either be involved actively in care of other patients, be awaiting another patient or be on call for actual emergency (major accident etc). These doctors can not be pulled out of their positions without negetively impacting care of other patients or depliting the reserve; both are unacceptable. Alternatively, hosptial can call a doctor for overtime which is poor use of limited funds therefore unacceptable.

Even with most generous interpretation of your argument, I see some people fucking dying by the application of a harsh principle.

I don't like racists or sexists myself. But I don't want them denied urgent medical treatment just because of their wrong beliefs. I don't want them left to die in a hospital, and I don't want them dying in a taxi or ambulance on the way to some other hospital. That is just too harsh a punishment for holding a wrong belief.

If we're going to sink to that level, then fuck having doctors at all. Get your "medical services" at market price and let the buyer beware.

I don't.
Patient in question was capable of giving consent. The said patient were also made aware of consequences of withholding said consent. By withholding said consent, the patient can be considered at fault for any and all consequences thereafter (provided they were made aware of these); therefore any resultant harm (upto and including death) to the patient is no longer the responsibility of hospital or medical practitioner but of the patient.

I have a lot of respect for your opinion, Great Nipples, but I decline to answer at this time. I'm busy in another thread, and for this thread I will direct my attentions to the posters I have posted in reply to. Ie, Patriqvinia, Novo Portugal, and Orham.

I may already have bitten off more than I can chew. Please don't dogpile me.

[Ermarian]

Patients should certainly be able to select whatever practice they want to go to - but if they go to a hospital they need to deal with the doctor who's currently available. In fact, if someone asks for a different doctor and makes it clear that they're doing so out of a sexist or racist prejudice, then this should be rejected as impractical regardless of whether or not a different doctor is available.

[The Fascist American Empire]

Gender I could understand, I'm pretty sure that a female patient wouldn't feel too too comfortable with a male doctor touching her, and I would feel pretty embarrassed about a female doctor touching me. But race? Sexuality? No, absolutely not. Gender of the doctor/nurse? Hm, maybe. I see why as far as gender is concerned.

[Land of the Trolls]

I think patient preference should be taken into account, but what if the best available doctor to treat their heart attack/stroke/ingrown toenail is a black Hispanic lesbian female? Wouldn't it be detrimental to find a less capable, but more acceptable doctor to treat this picky person?

[Jacobios]

Gender of the doctor/nurse? Hm, maybe. I see why as far as gender is concerned.

I think most hospitals try to respect the male-male and female-female thing, especially on treatment which is sensitive.

[AiliailiA]

That is frankly worse than a doctor refusing to treat a patient. It would take a few minutes to find some other doctor in the same hospital (though that is bad, as I said before) but at least in the meantime the patient is in a hospital, and if they develop acute symptoms and need urgent treatment it's there for them. If they're still able to give or withhold consent, they will buck up and accept the medical council of Dr. Wickramasingh, or lie there dying while they wait for Dr White to finish some other urgent medical appointment.

Is that harsh punishment for being a racist? Yes, but harsh decisions need to be made in Emergency. YOUR alternative — "go to some other hospital" — is just as harsh, and negligent of the patient's health and life to boot.

There may not be a Dr. White to find at that institution.

There may not be one available. In which case the patient faces the harsh choice of their "second-best" or hitting the road to some other hospital (which btw might not be able to meet their prefererence either)

I mean, suppose the patient is obstinate about their refusal to be treated by anyone who isn't of a specific ethnicity/race, or a specific religious affiliation, or whatever, but there's no one on staff qualified to provide the needed treatment which also meets the patient's criteria? It's perfectly conceivable that a patient who comes to a surgical clinic seeking care for appendicitis might have to swallow that this clinic just doesn't have a Mahayana Buddhist surgeon on staff.

Yep. Definitely could happen.

Also, absolutely any danger created for the patient's health in this hypothetical is of their own creation. As you said, they're already in a hospital, and furthermore I provided that this hypothetical hospital has people on staff that are perfectly willing to treat them. I even provided the patient the option of abandoning the problematic criterion and accepting care or seeking care at an alternative institution.

But what you didn't do — what you specifically ruled out — was giving the patient a second choice. If they don't want Dr Wikramasingh just because the doctor's name or her face bothers the patient, for a rather small overhead of hospital time (still regretable, but less than transporting the patient to another hospital) they could be offered Dr Sun Parq, another fully qualified doctor who comes across as more than a bit Asian.

Isn't this better than "here's a taxi voucher, taxi stand is left down the road from the front entrance, you're going to St Borg's" ..?

Now, I'd be willing to bend a bit and say that a clinic ought to be required to provide emergency transportation to an alternative institution which is better able to reasonably provide for the patient's treatment criteria if, and only if, all of the following holds true:

(a) The situation warrants emergency transportation.
(b) An alternative institution which can better provide for the patient's criteria is reasonably available.
(c) The institution to provide emergency transportation has the capacity to do so.
(d) Transportation of this sort is at the patient's own personal expense.

That seems like a reasonable accommodation to me, providing transportation if it's needed and requested.

I was going with that, until point (d). Providing transportaton at the patient's own expense is not providing transportation. You'd put them in an ambulance then bill them for it?

Give me your Liberal license, I'm clipping two points off it. You have six of twelve points left. Thankyou, here is your license back. Please be more careful in future.

Best case scenario really is that the racist (or sexist, or whatever) patient passes out, and the doctors decide what is best for them. Dr Wickramasingh saves the racist's life, and the racist stops being so racist when they realize they owe their life to a "Paki".

Really, the best case scenario is that the patient either willingly abandons the problematic criteria and receives care before passing out, or is successfully transported to an alternative institution where their criteria can be more adequately provided for. Also, I hasten to add that forcible provision of treatment against the patient's specified criteria is, irrespective of their ability to consent at the point treatment is actually provided, a violation of bodily sovereignty. It's a warranted violation, but it's still a violation.

Well if I said doctors should do anything to hasten the incapacity of the patient to consent, then I would willingly hand over my own Liberal license for you to take points off. But I didn't. This is a "best case scenario" standing apart from the doctor or the the patient. I don't want harm to come to either of them, and I want both of them to come out at the other side of with minimal damage and more importantly both alive.

Excuse me for wishing for a violation of the patient's consent, if that happens as a logical consequence of the patient's own decisions ... and after that doctors save the poor sod's life. I don't want to violate anyone's consent, nor do anything to their body they didn't explicitly consent to. But if they did not explictly consent, nor explicitly dissent from the operation which saves their life, then of course doctors should decide.

What doctors should not do, nor any hospital administrator, is punt the "too hard" patient to some other hospital. Triage decisions are difficult, they should not be palmed off on ambulance staff (or who-knows-what you mean by "transportation"). The hospital should make some effort beyond 'take the doctor we give you' to acomodate racists, sexists, etc, because despite their moral faults they are people. Their lives matter just as much as your life or my life does.

Actually I think yes. "Go to some other hospital" infringes on the rights of the patient which — while not always guaranteed by law outside the hospital — doctors specifically swore to protect when they entered their professional guild.

The specific concern I addressed was violation of bodily sovereignty. There is no violation of bodily sovereignty in telling a patient who wants a Mahayana Buddhist surgeon to remove their appendix that there is no such surgeon on staff, and that an alternative institution will have to be sought if this criterion is not abandoned. The problem of avoiding inflicting harm is resolved by providing emergency transportation to an alternative institution at the patient's expense or (if the situation warrants) providing care in contravention of the patient's demands for a Mahayana Buddhist surgeon.

The moment a sick person enters the hospital, the hospital has duty of care. If the patient is examined and found to be not not really sick at all, by all means kick then out on the street. But if they are sick, I think the hospital has an obligation to treat them: it shouldn't just punt them based on "you take the doctor we give you or gtfo". The hospital should make some accomodation for the moral weaknesses of patients in their hour of need, not try to reform their character in that hour with "see the error of your ways right now, or gtfo".

In our extreme examples (your Mahayana Buddhist surgeon, or my doctor fluent in Klingon) it is impossible for the hospital to serve he paitent ... but for the more likely and common preferences of racism and sexism it can be accomodated rather easily. The hospital is a mighty tool against prejudice, but to use it when it is most effective, against patients who are at its mercy, seems to me unchivalrous. It seems to me like fighting dirty. As a liberal, I have a problem with denying health care when the need is acute, just because the patient is being a douchenozzle.

[Snafturi]

There's valid reasons for wanting a doctor of a specific gender, religion, perhaps even race. Maybe it's a rape victim that would be traumatised, maybe they've had bad experiences with doctors of another religion and their religious practices (getting sick during Ramadan or Lent for example, it can be useful to have a doctor that understands).

There's also very bad reasons.

The problem is that I don't like the idea of judging who has a valid concern and who doesn't. Yeah, there are pretty obvious bad reasons, and reasons most would judge to be valid ...but who decides and how?

I'm also kinda uncomfortable with the idea that people might have to discuss potentially painful things in an attempt to convince someone that they aren't prejudiced, but have a valid concern.

I don't,however see this being a concern in acute, life threatening situations. People in danger of dying are generally not in a position to care about what race their doctor is. If they are, and are competent to make the decision, it should be their right to risk their own health by waiting. Just as a patient has the right to refuse treatment for other reasons.

[Patriarch]

I suppose another question after reading all these posts is whether people feel doctors, etc should be obligated to enable the racism, etc, of their patients.

[AiliailiA]

I suppose another question after reading all these posts is whether people feel doctors, etc should be obligated to enable the racism, etc, of their patients.

I don't really understand this "enabling" thing.

I believe in the duty of care, particularly for those in licensed professions like teacher, therapist, counselor, or law enforcement officer. I believe in duty of care for parents and wardens. I'm inclined towards a duty of care for everyone (ie, duty to aid: if you ignore someone dying in the street, you're an accomplice to manslaughter).

I still have nine of twelve points left on my Liberal license. But I really don't get this "enabling" thing. Can you explain it please?

[Orham]

There may not be one available. In which case the patient faces the harsh choice of their "second-best" or hitting the road to some other hospital (which btw might not be able to meet their prefererence either)

But what you didn't do — what you specifically ruled out — was giving the patient a second choice. If they don't want Dr Wikramasingh just because the doctor's name or her face bothers the patient, for a rather small overhead of hospital time (still regretable, but less than transporting the patient to another hospital) they could be offered Dr Sun Parq, another fully qualified doctor who comes across as more than a bit Asian.

Isn't this better than "here's a taxi voucher, taxi stand is left down the road from the front entrance, you're going to St Borg's" ..?

I ruled the possibility of giving a patient the option to choose from among entirety of the clinic's staff? I didn't mean to. I was assuming that all options among the staff at the hypothetical institution had already been exhausted. That's what I meant by "If you want care here, this is who provides it here."

...taxi voucher? I'm talking about an ambulance or medical helicopter. A vehicle equipped to provide emergency care enroute if necessary, and which (in the case of the ambulance) carries the legal authority to compel other vehicles to move and run lights/signs. I'm not talking about having the hospital hand the patient a single use bus pass or something. They might as well hand the patient a complimentary kazoo and a pogo stick with a flashy light, it'll be just as effective. Give me more credit than that.

I was going with that, until point (d). Providing transportaton at the patient's own expense is not providing transportation. You'd put them in an ambulance then bill them for it?

Give me your Liberal license, I'm clipping two points off it. You have six of twelve points left. Thankyou, here is your license back. Please be more careful in future.

Will it help if I state that the reason I want to charge for that service is because, in addition to being medically unnecessary, in addition to there being plainly available alternative treatment options of equivalent medicinal value/quality at the institution the patient is presently at, there is no net social benefit gained by transporting a patient between hospitals because the available staff (to include secondary options) at Point A is "too Paki" compared to those at Point B?

It may also help if I add the following provisions:

(a) Care provided enroute should still be covered by the NHS, as should care at the alternative institution.
(b) The cost of transportation and time should be charged on an at-cost basis, not on a for-profit basis.
(c) Ability to pay should not be a consideration in provision of transportation services.
(d) Billing should always take place after the fact.
(e) Provisions should be made for those who are unable to pay, to include the possibility of cancelling all charges.

Did that help?

Well if I said doctors should do anything to hasten the incapacity of the patient to consent, then I would willingly hand over my own Liberal license for you to take points off. But I didn't. This is a "best case scenario" standing apart from the doctor or the the patient. I don't want harm to come to either of them, and I want both of them to come out at the other side of with minimal damage and more importantly both alive.

Excuse me for wishing for a violation of the patient's consent, if that happens as a logical consequence of the patient's own decisions ... and after that doctors save the poor sod's life. I don't want to violate anyone's consent, nor do anything to their body they didn't explicitly consent to. But if they did not explictly consent, nor explicitly dissent from the operation which saves their life, then of course doctors should decide.

But they did explicitly dissent from the operation which saves their life. They just did so provisionally, with consent only being granted if their specific treatment criteria are met. Now, once the patient enters a state of shock and immediate treatment becomes necessary, and if the hospital has no means through which to reasonably meet the patient's criteria for treatment, of course I don't object to the hospital ignoring those criteria and saving the patient's life. That's why I said that it's a warranted violation of bodily sovereignty. I'm on your side on this one, I was just noting that we are calling for a provisional violation of individuals' bodily sovereignty.

What doctors should not do, nor any hospital administrator, is punt the "too hard" patient to some other hospital. Triage decisions are difficult, they should not be palmed off on ambulance staff (or who-knows-what you mean by "transportation"). The hospital should make some effort beyond 'take the doctor we give you' to acomodate racists, sexists, etc, because despite their moral faults they are people. Their lives matter just as much as your life or my life does.

I'm not talking about palming off difficult patients on ambulatory staff. I thought it would be alright to leave as an unstated assumption that by the time the ambulatory staff come into the picture the triage decision has already been made, that this would go without saying. What I'm effectively saying is that if it is determined that a patient may safely leave or be transported to an institution which is able to better provide for the patient's treatment criteria, and is not itself able to provide for these criteria, the option of transportation which may provide for the patient's safety enroute should be provided if reasonably possible. If not, the patient's treatment criteria should, to the extent that they are not medically necessary, be ignored and treatment should be promptly administered.

The moment a sick person enters the hospital, the hospital has duty of care. If the patient is examined and found to be not not really sick at all, by all means kick then out on the street. But if they are sick, I think the hospital has an obligation to treat them: it shouldn't just punt them based on "you take the doctor we give you or gtfo". The hospital should make some accomodation for the moral weaknesses of patients in their hour of need, not try to reform their character in that hour with "see the error of your ways right now, or gtfo".

In our extreme examples (your Mahayana Buddhist surgeon, or my doctor fluent in Klingon) it is impossible for the hospital to serve he paitent ... but for the more likely and common preferences of racism and sexism it can be accomodated rather easily. The hospital is a mighty tool against prejudice, but to use it when it is most effective, against patients who are at its mercy, seems to me unchivalrous. It seems to me like fighting dirty. As a liberal, I have a problem with denying health care when the need is acute, just because the patient is being a douchenozzle.

The objective I had in mind wasn't to strongarm the patient out of racism/sexism/religious prejudice/whatever by holding their health at ransom. It was to reasonably provide for the patient's treatment criteria while keeping attention to the limitations of medical institutions' abilities and the cost of accommodation for the NHS.

To reiterate: if, after triage has determined that the patient may be safely transported or allowed to leave entirely, a patient wishes to impose stringent treatment criteria the institution should offer both options. If triage has determined that the patient requires immediate care, and that both leaving entirely and transportation to an alternative institution are no longer viable options, the patient's specific treatment criteria should be ignored to the extent that they are medically unnecessary. That means that our friend will simply have to accept that a Pakistani doctor, or a Theravada Buddhist surgeon, or a doctor not fluent in Klingon, has provided their care due to extenuating circumstances which necessitated a violation of the patient's sovereignty.

[Hladgos]

Anesthesia first, then they can pick who they want to operate on them.

[Chinese Regions]

Well, that's a freedom expression issue, should they be allowed? Yes, but should they discriminate? No.

[Orham]

Anesthesia first, then they can pick who they want to operate on them.

You are indeed an odd potato.

[Hladgos]

Anesthesia first, then they can pick who they want to operate on them.

You are indeed an odd potato.

My views work for those who pay me to make them so.

[Scomagia]

Patients should certainly be able to select whatever practice they want to go to - but if they go to a hospital they need to deal with the doctor who's currently available. In fact, if someone asks for a different doctor and makes it clear that they're doing so out of a sexist or racist prejudice, then this should be rejected as impractical regardless of whether or not a different doctor is available.

What about asking for a different doctor when sexism or racism isn't the issue? Such as a patient who only wants a doctor of the same sex based on trauma, or a doctor of the opposite sex for the same reason? I cannot have another male look at me naked or touch me, for instance. It's not because I don't think they're competent but because of traumatic experiences. Should I be able to pick and choose?

[Geilinor]

Then it is basically:
1.Retarded is dying
2. Retarded wants a <insert characteristics> doctor
3. Retarded is warned that there is no <insert characteristics> doctor in the Hospital
4. Retarded stops being retarded and gets any doctor or Retarded stops being Retarded, forever.

(I edited plot twist numbers into your post)

1. Precept accepted. Not all Casualty patients are dying, but for the sake of argument ...
2. On-topic. Patient discriminates on grounds you or I would consider irrelevant to the quality of medical treatment.
3. This is pretty unlikely, for all likely values of <characteristic>, but let's assume the patient asked for a double-amputee doctor who speaks fluent Klingon ... for the sake of argument ...
4. The patient realizes that their demand is unreasonable and settles for "second best" practitioner (anyone in the building who speaks Klingon), gets sedated and then treated. Or they don't. They leave the hospital as sick as they came in or they fucking die.

Even with most generous interpretation of your argument, I see some people fucking dying by the application of a harsh principle.

I don't like racists or sexists myself. But I don't want them denied urgent medical treatment just because of their wrong beliefs. I don't want them left to die in a hospital, and I don't want them dying in a taxi or ambulance on the way to some other hospital. That is just too harsh a punishment for holding a wrong belief.

If we're going to sink to that level, then fuck having doctors at all. Get your "medical services" at market price and let the buyer beware.

Or you take their refusal to get treated as a withholding of consent.

[Geilinor]

Patients should certainly be able to select whatever practice they want to go to - but if they go to a hospital they need to deal with the doctor who's currently available. In fact, if someone asks for a different doctor and makes it clear that they're doing so out of a sexist or racist prejudice, then this should be rejected as impractical regardless of whether or not a different doctor is available.

What about asking for a different doctor when sexism or racism isn't the issue? Such as a patient who only wants a doctor of the same sex based on trauma, or a doctor of the opposite sex for the same reason? I cannot have another male look at me naked or touch me, for instance. It's not because I don't think they're competent but because of traumatic experiences. Should I be able to pick and choose?

That's an exception, because of reasons that one can explain. One cannot logically explain why they can't have a black or Asian doctor, on the other hand.

[Nomadic sister of shawnas north africa]

This happen To me I had a Egyptian doctor doing the birth care of My baby son, then when I ' move To America I had a India - American doctor who I did not like In his care, with In 6 mo 's I move back home from class In the state's and My old doctor was over my health care and birth of my child I under him and his prenatal care vs the American India doctor who spoke very good English, versus Arabic. Now discrimination against doctors To care for your child Or baby? India the country has some of the best doctors In the freeworld today there doctors In western countries and middle eastern An Asian? Nigerian doctors are smart In health care plans if you have An Nigerian doctor,